title: Determinants and burden of chronic kidney disease in the population-based CoLaus study: a cross-sectional analysis.
abstract: BACKGROUND
  Chronic kidney disease (CKD) represents an increasing health burden. We present the population-based prevalence of CKD and compare the CKD Epidemiology collaboration (CKD-EPI) and modification of diet in renal disease (MDRD) equations to estimate the glomerular filtration rate, using the revised CKD classification with three albuminuria classes. We also explore factors associated with CKD.
  
  
  METHODS
  The Swiss population-based, cross-sectional CoLaus study conducted in Lausanne (2003-2006) included 2810 men and 3111 women aged 35-75. CKD prevalence was assessed using CKD-EPI and MDRD equations and albuminuria estimated by the albumin-to-creatinine ratio in spot morning urine. Multivariate logistic regression was used to analyse determinants of CKD.
  
  
  RESULTS
  Prevalence [95% confidence interval (CI)] of all stages CKD was 10.0% (9.2-10.8%) with CKD-EPI and 13.8% (12.9-14.6%) with MDRD. Using the revised CKD classification, the prevalence of low-, medium-, high- and very high-risk groups was 90.0, 8.46, 1.18 and 0.35% with CKD-EPI, respectively. With MDRD, the corresponding values were 86.24, 11.86, 1.55 and 0.35%. Using the revised classification, CKD-EPI systematically reclassified people in a lower risk category than MDRD. Age and obesity were more strongly associated with CKD in men [odds ratio (95% CI): 2.23(1.95; 2.56) per 10 years and 3.05(2.08;4.47), respectively] than in women [1.46 (1.29; 1.65) and 1.78 (1.30;2.44), respectively]. Hypertension, type 2 diabetes, serum homocysteine and uric acid were positively independently associated with CKD in men and women.
  
  
  CONCLUSIONS
  One in 10 adults suffers from CKD in the population of Lausanne. CKD-EPI systematically reclassifies people in a lower CKD risk category than MDRD. Serum homocysteine and uric acid levels are associated with CKD independently of classical risk factors such as age, hypertension and diabetes.
authors.affiliation: Service of Nephrology, Geneva University Hospital, Geneva, Switzerland.
authors.forename: Belén
authors.initials: B
authors.lastname: Ponte
authors.forename: Menno
authors.initials: M
authors.lastname: Pruijm
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Martin
authors.forename: Michel
authors.initials: M
authors.lastname: Burnier
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.forename: Peter
authors.initials: P
authors.lastname: Vollenweider
authors.forename: Murielle
authors.initials: M
authors.lastname: Bochud
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology* / Q000209:etiology; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology*; D003404:Creatinine / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: CKD-EPI equation; MDRD equation; chronic kidney disease; population-based study; prevalence